OGTT with Insulin results – who is familiar with interpreting results?

[JMC85]

I live in the USA but I’m posting here because this is one of the only sites that seems to have a thread for reactive hypoglycemia and I’ve read a few discussions of people who seem to be negative for diabetes but still hypoglycemic. I’ve been able to learn so much by reading other people’s stories and discussions online. It’s really given me more clarity on what I’m experiencing and even inspired me to switch doctors and I found a guy who’s awesome and takes me seriously. Thank you guys!


I took a test that I read about on here, which is an OGTT but with insulin levels instead of glucose. Dr. Kraft was a big proponent of these as I’ve seen some people talk about. Unfortunately, I’m having a difficult time finding online discussions and information regarding results of the test. I’m going to discuss it with my doctor on my appt next month, but wanted to ask about it here too.

Long story short – normal hba1c and no T1 antibodies. However, my blood sugar goes very high after I eat and then often times very low. Hitting over 11 sometimes and then down to about 2.7
I converted all measurements to what’s used in the UK

Here’s the results from my 3 hour insulin test:
Fasting: 21 (pmol/L)
1 hour: 330.4
2 hour: 80.5
3 hour 17.5

I test my own blood sugar during that OGTT and got:
Fasting: 5.2
1 hour: 11
2 hour: 5.5
3 hour: 3.0

(I previously did a 2hr-OGTT of just blood sugar from a lab before, so the one I have that’s officially from a lab is this):
Fasting: 4.6
1 hour: 12.9
2 hour: 5.1
3 hour: 2.7 (I did this 3rd hour reading on my own as it was a 2 hour OGTT).


I feel a little surprised to get the insulin results I did, because I expected the numbers to be higher to match the lows I feel at the 3rd hour. Are the insulin results I got normal? I remember looking at a chart a while ago that showed high readings, but those might have been for insulin resistance / T2. So perhaps mine are BELOW what they should be?
I also have a low c peptide of 1.48 pmol/L (fasting) (I believe I converted correctly. I was 0.66 for the measurement scale used in the USA)


At this point, I’m accepting that what I’m likely experiencing is reactive hypoglycemia, not diabetes. But I’m going to keep testing my blood sugar, and periodically my c-peptide to see if it goes down more, as I know many people experienced reactive hypoglycemia for years before presenting LADA, so I’ll be conscious about that possibility. Just frustrating that I wish there was a way I could medicate for this RH because it is incredibly burdensome. But oh well. I’m disciplined and I can stick to a LCHF diet since that appears to be the only solution.

 

[ert]

An interesting set of results supporting reactive hypoglycemia. I think your c-peptide is currently normal 80 - 250 pmol/L (at 148? if using pmol/L). However, your phase 1 insulin response to glucose looks below what it should be, which would support why you spiked your blood sugars. See: https://emedicine.medscape.com/article/2089224-overview
Something to ask your specialist anyhow.

 

[Lamont D]

Hi and welcome to the forum.
I'm really glad you found a doctor that has the open mind that you can have non diabetic post prandial Hypoglycaemia, reactive hypoglycaemia.
Having had quite a few eOGTTs, I can see why you have been diagnosed though a further fasting test will give you a specific diagnosis.
You are definitely non diabetic, you are getting high spikes from normal levels because for some reason, in my case and probably in yours, after the glucose derived from food or drink, the insulin response is abnormal and not enough for the glucose.
Then because of the high glucose at one hour of your test is near the spike, what is called an overshoot of insulin is triggered, this is why in your test the insulin levels are as high as the glucose spike is, to drive the blood glucose levels down, but again as the high levels of insulin will drive your blood glucose levels down into hypoglycaemia.
Of course, because of the fluctuations in blood glucose levels, this causes many of the symptoms you have experienced.

I have been diagnosed now for over seven years and LCHF has definitely been the only treatment that can guarantee you of having on or around normal blood levels.
Having meals and drinks that are carb and sugar free, is the only treatment to get your health, your life, your well being and control your condition.

There is a lot more than carbs and sugar, I have found that only fresh food can help with control. Certain fats that are considered healthy and some vegetables, vegetable oils and industrial sugars and ingredients can hinder your health. Some other additives are also not recommended.
You will have to accept that what nutritionists and dieticians claim to be healthy complex carbs, will still cause the high glucose. You will have to experiment what foods you decide to eat are healthy for you. The majority of professionals will insist on some carbs, but I found that regardless of how they label them, they will still cause the Hypoglycaemia. I have kept a food diary for many years, this has helped me so much, and testing before and after eating is so important to understand what is going on.
Insulin resistance will be a problem until you get that down through low carb diet, and exercise, which will help but you have to be aware of overdoing it because of a liver dump of glucose will trigger a hypo.

I would definitely recommend reading about reactive hypoglycaemia on our forum, because there is not just reactive hypoglycaemia but other conditions that are very similar in symptoms of RH and diabetes and metabolic conditions.

I'm sure that you have plenty of questions about dietary advice and how to achieve constant blood levels and perhaps as I came to realise that a Keto diet and intermittent fasting is for us RH ers the best treatment.

Keep asking, keep safe.

Best wishes